Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-49693
Studer, G; Glanzmann, C; Studer, S P; Grätz, K W; Bredell, M; Locher, M C; Lütolf, U M; Zwahlen, R A (2011). Risk-adapted dental care prior to intensity-modulated radiotherapy (IMRT). Schweizer Monatsschrift für Zahnmedizin SMfZ, 121(3):216-229.
|Published Version (English)|
BACKGROUND: At the Clinic for Radiation Oncology at the Zurich University Hospital (UniversitätsSpital Zürich [USZ]), head-and-neck tumor (HNT) patients have been treated with intensity-modulated radiotherapy (IMRT) since 01/2002 (n 〉 800). This method causes less damage to normal tissues adjacent to the tumor, and thus it was possible in the head/neck region to markedly reduce the rate of osteoradionecrosis (ORN), in addition to reducing the rate of severe xerostomia. Based on these results, risk-adapted dental care (RaDC) was adopted by our clinic as the standard mode of pre-IMRT dental treatment. The guidelines as formulated by Grötz et al. were respected. ORN prophylaxis is one of the most important goals of pre-radiotherapy dental care, and the ORN rate is a measurable parameter for the efficacy of dental care, given a certain radiation technique. The aim of the present study was therefore to evaluate the efficacy of RaDC as reflected by the ORN rate of our IMRT patients.
MATERIALS AND METHODS:
IN August 2006, RaDC was clinically implemented and has been used for all HNT patients prior to IMRT since then. Before that (01/2002-07/2006), dental restorations were performed according to the usual procedure.
The rate of grade-2 ORN was similar in the conventionally treated and RaDC groups (2% and 1%, resp.); grade-3 ORN had not occurred by the time the analysis was conducted. As expected, fewer extractions were performed in the RaDC cohort (no extractions in 47% of the RaDC/IMRT cohort vs. 27% in the IMRT cohort receiving conventional dental care).
After considerably less invasive dental treatment, no higher-grade ORN occurred and no ORN-related jaw resections were required. Based on the present data, risk-adapted minimally invasive dental care is recommended before IMRT.
|Item Type:||Journal Article, refereed, original work|
|Communities & Collections:||04 Faculty of Medicine > University Hospital Zurich > Clinic for Radiation Oncology|
|DDC:||610 Medicine & health|
|Deposited On:||19 Sep 2011 13:19|
|Last Modified:||16 Oct 2012 17:18|
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